Background: Women with previous two or
more caesarean deliveries are usually
managed by elective cesarean section to avoid
the possible risks of labor.
Objective: To compare the relative risks of
maternal and fetal outcomes in emergency
versus elective previous two or more
caesarean deliveries
Design: Randomized prospective clinical
study
Setting: Al-Elweya Maternity Teaching
Hospital, from 1st of March to 31st of
September 2008.
Methods: The study groups, those who had
previous two or more caesarean deliveries,
were included from the hospital admissions.
The 1st group (102 women) presented in labor
and was managed by caesarean delivery as
soon as it was possible. The second group (78
women) was admitted for elective cesarean
delivery.
The main maternal outcomes were intra
operative complications, including
hysterectomy, scar dehiscence, bladder
injuries, uterine and internal iliac arteries
ligation, and blood transfusion. Postoperative
maternal outcomes were severe morbidity
including bleeding, fever, urinary tract
infection, blood transfusion, the need to
Intensive Care Unit admission and
readmission. The fetal outcomes measures
were Apgar score at one and five minutes,
respiratory distress syndrome (RDS),
admission to the neonatal intensive care unit
and fetal loss up to hospital discharge.
Results: Both groups were comparable in
demographic, social and past obstetric history
characteristics. Intra operative complications
showed significant difference in bowel
adhesions (RR 0.35, 95% CI 0.14- 0.88), and
blood transfusion (RR 0.51, 95% CI 0.28-
0.94). There was statistical significant
difference in the mobilization time 7.2 hours
and 9.3 hours in emergency and elective
groups respectively (p= 0.0009), also in
feeding time, it was shorter after emergency
caesarean section (P=0.0224), and in the
hospital stay 24.6 and 32.6 hours respectively
(p=0.0001). There was no statistical difference
in post operative complications. Fetal
outcomes showed no statistical significant
difference in fetal loss, respiratory distress and
readmission.
Conclusion: Women with previous two or
more caesarean deliveries can wait until
starting labor for doing cesarean delivery
without increasing risks to the mother and
fetus.
The primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.
The developing countries, like our country Iraq suffer from deep comprehensive structural crisis, manifestations and a clear imbalance between the demand and the supply sides. The overall imbalance in the external balance. As a consequence, this caused the accumulation of foreign debts or failure in the implementation of economic development programs. The countries which are forced to resort to the International Monitoring Funds, and the World Bank for assistance and to express an opinion on policies that include restrictions controls that belong to the monetary, and fiscal side group, imposed on the economies crisis, as a condition for returning to normal which called reform programs. The organize of the events of radical changes in the
... Show MoreThe objective of this study is to ascertain the pivotal role of headlines in captivating viewers' attention toward news bulletins. Additionally, it aims to explore the factors that contribute to the correlation between headlines and the public's acceptance or rejection of the meticulously crafted news articles presented through these bulletins. The study delves into the mechanisms employed in writing and editing headlines, focusing on their style, expert composition, and intriguing nature. These factors inevitably influence the level of acceptance and engagement of the viewership with the news articles disseminated via the news bulletins. Employing a descriptive methodology, the researcher distributed 200 question
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Most of the industrial organization in the world became suffering from the problem of the pollution of the poisonous chemicals things, this urged to depend on the principle of the responsible production, because it has the positive role by dealing with these chemical things and to safe the health of the society, due to the main goal of this study is to restrict the role responsible production in accomplishing the system of the environmental management through an actual study in the northern gas company in Kirkuk province, the topic has acquired a big importance bacause there were a limited number of studies and res
... Show MoreThe Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected a
... Show MoreThe main idea of this research stems from the challenges faced by managers working in service organizations, which are responsible for providing services to a large segment of the society. Therefore, they must use strategic intelligence to manage their performance and enhance their performance to serve the society. Organizational Performance The present study aimed to identify the concepts of strategic intelligence and its impact on organizational performance to raise awareness and awareness of the importance of the subject for the university. And to identify the perceptions of leaders about strategic intelligence and determine the nature of the relationship (impact and correlation) between strategic inte
... Show MoreAllowing Iraqi companies to use multiple systems and policies leads to varying levels of disclosure and no high symmetry between report preparers and users, and that the adoption of integrated reporting can reduce information asymmetry. The theoretical side addressed the concepts of these variables, and in the practical side the binary variable (0, 1) was used. To compensate for the value of the independent variable (integrated reporting) based on the Central Bank of Iraq’s classification of banks according to the (CAMLES) index, and the dependent variable (information asymmetry) was measured through two measures (price difference, unusual return), the research community was represented by (5) Banks out of the total of banks li
... Show MoreA field study investigated the degree of need for managers working in the directories of education to develop their skills for the exercise of administrative empowerment, and it adopted the descriptive analytical approach. The research community, was determined which consisted of 126 principals, and the sample was selected with arte of randomly Statistics and by (100%) of the research community, as the number of respondents was (126) of managers working in the directories of education. A questionnaire was built which included 40 items distributed among the fields of study. Researchers verified its validity and reliability. The research data were analyzed using software (SPSS), the questionnaire was applied in the second semester of the a
... Show MoreA study of Zooplankton community has been carried out at four selected sites on Dukan Lake. Samples of water and zooplankton were collected monthly for the period from July 2015 to February 2016. Some physical and chemical properties of water were studied and the results showed that the air temperature were ranged from 0 to 36.16 °C, water temperature ranged from 2.83 to 34.66 °C, hydrogen ion concentration of studied sites were found to lie in alkaline side, it was ranged between 6.87 to 8.57, electrical conductivity ranged from 190.79 to 850.08 µs.cm¹, turbidity ranged from 0.9-7.7 NTU, and dissolved oxygen from 3.3 to 6.8 mg.l-¹ while BOD5 were ranged from 0.53 to 34.66 mg.l-¹. Concerning to the zooplankton, 37 species were ident
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